Broker Check

COVID‑19 vaccine coverage

December 14, 2020
Share |

COVID‑19 Vaccine Coverage

At Independence, they are committed to giving their members and customers the information they need to understand the ever‑changing COVID‑19 environment. We are hopeful that once vaccines start to become widely available we will be able to beat the virus.

Independence will cover the cost of health care providers administering the COVID‑19 vaccine with no cost‑sharing to our members, in accordance with federal and state laws and regulations. As vaccines are approved by the Food and Drug Administration (FDA) for Emergency Use Authorization (EUA), the federal government will initially supply the vaccine to health care providers at no cost.

The COVID‑19 vaccine will be covered for Commercial members as a preventive service, similar to the flu vaccine, and the charges for administering the vaccine will be payable under the Medical benefit and at the pharmacy.

Here are a few additional points around cost‑sharing as it pertains to specific plan design and/or site‑of‑service scenarios:

  • Cost‑sharing for high‑deductible health plan (HDHP) members will be waived/covered.
  • Cost‑sharing for COVID‑19 vaccines administered by a home health agency will be waived/covered. Home‑bound requirement will be waived for vaccine administration.
  • Office visit cost‑sharing will apply if a member receives the COVID‑19 vaccine during an office visit that is not considered preventative, billed with an E&M code for an acute care visit.

Distribution

As with all vaccines, Independence has no control over the availability and prioritization of distributing the vaccine. Distribution of the COVID‑19 vaccine will be controlled by the federal government, in collaboration with state and local governments. More information can be found on the CDC website.